Dr. Isadore Rosenfeld's 2005 Breakthrough Health

By Isadore Rosenfeld, M.D.

Published by Rodale

January 2005; $14.99US/$20.99CAN; 1-59486-140-4

This all-new edition of Dr. Isadore Rosenfeld's Breakthrough Health is the one source you can trust for the most accurate, understandable, and up-to-date health and medical information.

Once again, Dr. Rosenfeld combines his trademark humor and enormous depth of knowledge to translate the latest medical news into practical information for the whole family. For example, did you know that there's a spice in your kitchen cabinet that lowers blood sugar levels in people with diabetes? Do you know which medicine-cabinet staple you must get rid of -- and what you should replace it with? You'll learn about surprising medical uses for Botox that do more for your health than erase wrinkles, a breakthrough sound-wave treatment for shoulder pain, and why lycopene supplements aren't as good as a red, ripe tomato for preventing prostate cancer. Plus lots more of the latest advances in vitamins, supplements, herbs, vaccines, and pharmaceutical drugs.

This year's edition covers such diverse topics as arthritis, heart disease, nosebleeds, and weight loss. For these concerns and many more, Dr. Rosenfeld separates hype from hope and imparts the same bottom-line advice to readers that he gives his own patients.

Author

Dr. Isadore Rosenfeld is the best-selling author of nine books, including Live Now, Age Later and Dr. Rosenfeld's Guide to Alternative Medicine. He is a distinguished member of the faculty at New York-Presbyterian Hospital/Weill Medical College of Cornell University and attending physician at New York-Presbyterian Hospital and Memorial Sloan-Kettering Cancer Center. Dr. Rosenfeld can be seen every Sunday morning on his popular show Sunday Housecall on Fox News Channel. He is the health editor and a regular columnist for Parade magazine.

Excerpt

The following is an excerpt from the book Dr. Isadore Rosenfeld's 2005 Breakthrough Health: Up-to-the-Minute Medical News You Need to Know

By Isadore Rosenfeld, M.D.

Published by Rodale; January 2005; $14.99US/$20.99CAN;1-59486-140-4

Copyright © 2005 Isadore Rosenfeld, M.D.

Arthritis

Combination Treatment for Rheumatoid Arthritis

The term arthritis is not a specific diagnosis. It simply means that one or more of your joints are inflamed, for which there are more than 100 different possible causes. For example, you may have been injured (traumatic arthritis), or you may have gout (gouty arthritis), or one of your joints may have been infected by any one of a number of agents, including gonorrhea. The two most common forms of arthritis, however, are osteoarthritis and rheumatoid arthritis.

Osteoarthritis is the result of long-standing wear and tear on the joints that develops usually as we grow older. It involves a loss of cartilage and a change in bone constitution. Rheumatoid arthritis is totally different and results from inflammation of the joints that have been attacked because of a faulty immune system. It affects more than 2.1 million Americans, of whom 1.5 million are women. It's progressive, chronic, and often crippling. It usually starts in middle age but may occur in children and young adults. Unlike osteoarthritis, which is confined to the joints, rheumatoid arthritis usually also involves internal organs such as the heart and lungs.

There are several ways to treat rheumatoid arthritis, but the first goal is to reduce symptoms -- joint pain, stiffness, and swelling. This can be done with drugs such as aspirin, nonsteroidal anti-inflammatories (NSAIDs), and corticosteroids. Exercise, heat, cold, and physiotherapy also play an important role. In addition, a category of medications, referred to as disease-modifying antirheumatic drugs (DMARDS) can affect the underlying disease process in addition to reducing pain. For the past 20 years, the DMARD of choice has been methotrexate (Rheumatrex), originally developed for the treatment of various cancers. Unfortunately, it is effective in only one in three patients with rheumatoid arthritis.

More recently, a new class of drugs -- the prototype of which is Enbrel (etanercept) -- has become available. It targets and neutralizes an inflammation-causing protein called tumor necrosis factor. Patients who don't respond to methotrexate are given Enbrel, but heretofore the drugs were not usually taken together.

Another form of therapy, called Prosorba, filters the blood of patients with rheumatoid arthritis and removes the inflammatory antibodies from the circulation. Older agents such as gold therapy, antimalarial medications, a variety of biologic agents, azathioprine (Azasan), and cyclosporine (Sandimmune) may also help. When joints have been badly damaged and are painful, and the patient is crippled and immobilized, surgery may be necessary.

Here's What's New

According to a report published in the Lancet, treating rheumatoid arthritis with a combination of methotrexate and Enbrel is more than twice as effective as either drug alone. Here are the data: After using both drugs for 1 year, 35 percent of 682 rheumatoid arthritis patients went into remission as compared with 13 percent of those on methotrexate alone and 16 percent taking only Enbrel. The other point to note is that all these patients had been suffering from the disease for years. It may be that starting this combination therapy sooner could slow down the rate of joint destruction and have an even greater effect.

The Bottom Line

There is no cure for rheumatoid arthritis. However, there are several different ways to reduce the joint pain, swelling, and deformity. Combining methotrexate and Enbrel, both of which affect the disease mechanism in addition to improving its symptoms, is more effective than either one alone. And the earlier this is done, the better.

Reprinted from: Dr. Isadore Rosenfeld's 2005 Breakthrough Health, by Isadore Rosenfeld, M.D. © 2005 Dr. Isadore Rosenfeld, M.D. Permission granted by Rodale, Inc., Emmaus, PA 18098. Available wherever books are sold or directly from the publisher by calling (800) 848-4735 or visit their website at www.rodalestore.com

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